Hearing Loss Identification and Diagnosis

“Does my child have a hearing loss?”

Hearing loss is invisible – it is not always apparent that a child is having hearing difficulties. US Hospitals routinely perform hearing screening on infants in the first 24-48 hours after birth. If an infant fails the initial screening, he or she is usually scheduled for a second screening a few weeks later. However, sometimes infants who pass the hearing screening at birth may exhibit signs of hearing loss as they age.

This section provides information and resources about identifying hearing loss from birth, hearing loss in young children due to ear infections and identifying hearing loss in school-aged children.

Hearing loss may be identified at birth or any time thereafter. If there are any concerns regarding a child’s ability to hear (at home or school) do not hesitate to have their hearing tested. It is never a waste of time for an audiologist to report that a child has normal hearing.

Identifying Hearing Loss at Birth

Most congenital (present at birth) hearing loss can be identified within 1-2 days of birth via hospital hearing screening. In the US, almost all babies have their hearing screened within a day of being born. Approximately 1 out of 10 newborns who fail hearing screening end up being diagnosed with hearing loss. Newborns who spend time in a neonatal intensive care unit (NICU) have a greater chance of being identified with a hearing loss than those children with no birth complications.

As mentioned above, children with mild or progressive hearing loss may pass their newborn hearing screening. As a result, only about half of children with hearing loss will have their hearing loss identified at birth – there continue to be children who will develop a hearing loss as the years progress. This can be due to a hearing loss that worsens over time, an accident causing damage to structures of the ear, over-exposure to noise or specific medications that cause damage to the cochlea. A later on-set hearing loss may not be obvious and therefore may go undiagnosed for a long period of time. In a developing child hearing loss can look like:

Turns up the TV volume incredibly high or sits very close to the TV to hear.

Has problems academically, especially if they weren’t present before.

Has speech or language delays or problems articulating things.

Watches others in order to imitate their actions, at home or in school.

Complains of ear pain, earaches or noises.

Cannot understand over the phone or switches ears frequently while talking on the phone.

Says “what?” or “huh?” several times a day.

Watches a speaker’s face very intently – many children’s hearing loss escapes detection because they are very successful lip readers.

Not all children with a hearing loss will present with learning issues that will trigger a hearing evaluation. In fact, the referral for a hearing test often depends on whether the family or teacher thinks that the child’s learning issues are due to hearing loss. From the list of potential observable behaviors above, it isn’t surprising that many children with hearing loss are misidentified as having attention deficit disorders (ADD), behavior disorders, speech and language disorder (delay due to limited access – not a disorder), or even cognitive/developmental delay.

It is only through mass hearing screenings that we will be able to identify children with previously unidentified hearing loss in a systematic manner. In the absence of such mass screenings, if your child or student demonstrates the above behaviors please have them seen by an audiologist for a hearing assessment.